Quality of life, its factors, and sociodemographic characteristics of Polish women with lipedema.

BACKGROUND: Lipedema is a type of subcutaneous adipose tissue disorder that affects mainly women. Its main symptom is bilateral fat accumulation on the extremities with associated pain in the affected areas. Despite growing interest in lipedema among patients and medical health professionals, lipedema is still often misdiagnosed, misunderstood, and mistreated. To promote better understanding of lipedema, we aimed to investigate factors related to the quality of life and describe selected sociodemographic and clinical characteristics of women with lipedema in Poland. METHODS: We conducted a cross-sectional online survey that was completed by 98 women with lipedema. The participants responded to questionnaires regarding quality of life, sociodemographic and clinical characteristics, and depression symptom severity. RESULTS: The participants reported low quality of life and high severity of depressive symptoms. The more severe the symptoms related to pain, heaviness, and swelling, the lower the quality of life. Further analyses showed that depression severity mediated this relationship. CONCLUSIONS: The current study provides initial information on screening questions, lipedema symptoms, and comorbidities, pointing to the areas needing in-depth investigation. Further steps to improve quality of life in women with lipedema and to reduce health costs should include the education of medical health professionals, using diagnostic tools that allow for differentiation among diagnoses and precise health risk assessment, and creating Polish treatment guidelines for lipedema.

Changes in Cortical Sensitivity to Infant Facial Cues From Pregnancy to Motherhood Predict Mother-Infant Bonding.

The transition to motherhood triggers changes in human brain structure that may facilitate mother-infant bonding. Although much research on maternal cortical responses to infant faces has focused on the postpartum period, no previous study has examined whether longitudinal functional changes in the maternal cortex during pregnancy and postpartum are associated with mother-infant bonding. Using electroencephalography, prenatal to postnatal changes in cortical sensitivity (P1, P2, late positive potential, N170 event-related potentials) to infant and adult faces were examined in relation to reported mother-infant bonding in 40 mothers (Mage  = 30.5 years). Prenatal to postnatal increases in P1 and P2 responses to infant faces predicted stronger bonding. Findings suggest that cortical changes in attention allocation rather than in face-specific encoding enhance bonding.

Depression and appearance-related distress in functioning with lipedema.

Lipedema is a chronic, progressive adipose tissue disorder that may impact the quality of life of women who suffer from it. The main aim of this study was to asses the role of perceived symptom severity, physical and psychological functioning with the disease in predicting quality of life in patients with lipedema. We conducted an online study with 329 participants who responded to five questionnaires measuring quality of life (World Health Organization Quality of Life BREF), lipedema symptom severity, mobility (Lower Extremity Functional Scale), depression (Patients Health Questionnaire-9), and appearance-related distress (Derriford Appearance Scale 24). Multiple hierarchical regression analyses showed that appearance-related distress and depression explained significantly more variance in quality of life when added to the symptom severity and mobility. Lower quality of life was predicted by higher symptom severity, lower mobility, higher appearance-related distress and higher depression severity. Appearance-related distress and depression constitute important aspects of psychological functioning in women with lipedema. Considering their relationship with quality of life, their assessment should be included in lipedema treatment with appropriate interventions aimed at decreasing appearance-related distress, as well as preventing and addressing depression.

Quality of life in women with lipoedema: a contextual behavioral approach.

PURPOSE: Lipoedema is a chronic, progressive adipose disorder of unknown etiology, often underdiagnosed or misdiagnosed as obesity. It manifests itself with accumulation of the fat in lower parts of the body and associated edema and, due to numerous physical and psychological consequences, affects the quality of life (QOL) of those who suffer. The aim of this study was to investigate the psychological factors that might have an impact on the QOL of women with lipoedema from the contextual behavioral viewpoint. METHODS: In an Internet-based cross-sectional study, women suffering from lipoedema (N = 120) were asked to fill in questionnaires assessing: symptom severity, QOL (WHOQOL-BREF), satisfaction with life (SWLS), psychological flexibility (Acceptance and Action Questionnaire-II), social connectedness (Social Connectedness Scale-Revised) and other psychological factors. The majority of participants were from the USA, the UK, and Australia. RESULTS: Multiple hierarchical regression analyses showed that a higher level of QOL was predicted by higher levels of psychological flexibility and social connectedness, while controlling for symptom severity. Higher level of SWL was predicted only by higher level of social connectedness. CONCLUSIONS: Acceptance and Commitment Therapy with psychological flexibility as the target of change and Functional Analytic Psychotherapy with social connectedness as the target of change might be useful in treating women with lipoedema; however, further research in this area is needed. The authors conclude that psychological and biomedical interventions for women with lipoedema and their QOL merit more attention from researchers and the medical community than is currently received.

Social Perspective Taking and Empathy in Children with Fetal Alcohol Spectrum Disorders.

Children with fetal alcohol spectrum disorders (FASD) show sociobehavioral impairments; however, the social cognitive profile contributing to these impairments is poorly understood. This study compared social perspective taking and empathy in children with FASD versus typically developing controls (TDC). Thirty-seven children with FASD and 21 TDC participated. Measures included parent-rated CBCL and SSIS, and NEPSY-II Theory of Mind, Test of Social Cognition and Index of Empathy. Parents rated the FASD group higher than TDC on indices of behavior problems and lower on indices of social skills and empathy. Children with FASD scored significantly below TDC on tasks requiring complex social cognition. The majority of correlations between social cognition and parent-ratings were not significant in FASD and TDC, with the exception of a negative correlation between self-reported empathy and parent-rated behavior difficulties in TDC. FASD subgroup analyses revealed lower theory of mind and empathy scores among children with ARND than pFAS/FAS. With regard to sex, males with FASD were rated as having more behavior difficulties than females, whereas TDC females obtained higher empathy ratings than males. In both groups, females scored higher on theory of mind and empathy indices. On theory of mind tasks, older children with FASD performed below younger, whereas younger TDC children performed more poorly than older. Children with FASD show reduced functioning on indices of sociobehavioral and social cognition, and the effects are influenced by sex and age. These findings provide insight into the clinical and social profile of children with FASD.

Hippocampal abnormalities in youth with alcohol-related neurodevelopmental disorder.

Individuals diagnosed with alcohol-related neurodevelopmental disorder (ARND) exhibit difficulty on hippocampally mediated memory tasks and show reduced hippocampal size. However inconsistencies exist regarding the affected memory functions and where within the hippocampi effects occur. Given recent studies showing anterior and posterior segments support distinct memory functions and sex dimorphisms in hippocampal function, we asked whether these factors influence memory performance in youth with ARND (n = 18) and typically developing controls (n = 17). Participants received a battery of memory tests and a structural MRI scan. Right and left hippocampi were manually traced; anterior and posterior segments were delineated at the uncus. Measured were intracranial volumes (ICV) and right and left hippocampi and hippocampal segments. Volumes were adjusted for ICV. Relative to controls, the ARND group had lower IQs and memory performance on most tasks and marginally smaller ICVs. Left and right hippocampal volumes and posterior segments were smaller in the ARND group. Although no sex differences were observed between groups, females overall had larger anterior hippocampi than males. Positive and negative associations between hippocampal and selective memory indices were found in the ARND group only. These findings are the first to suggest that posterior hippocampal development may be compromised in youth with ARND.

Dynamics of the increase in strength and girth of quadriceps muscle after the reconstruction of anterior cruciate ligament.

BACKGROUND: Reconstruction is the method of choice in the treatment of ACL rupture. Postoperative rehabilitation is a very important aspect of therapeutic management. One of priority elements is to regain proper strength and function of the quadriceps muscle in a short time. The aim of this study was to estimate the dynamics of the increase in strength and girth of quadriceps after ACL reconstruction. MATERIAL AND METHODS: The examined group consisted of 30 patients who had undergone arthroscopic assisted quadruple bundle dual channel ACL reconstruction surgery in years 2010-2011. The average age of the patients at the time of operation was 31.7 years (range 17-53). Each patient was examined 4 times: before the surgery as well as in the second, sixth and twelfth week after the reconstruction. RESULTS: Examination revealed a significant increase in quadriceps girth, with peak increase rate observed within the two first weeks after the surgery. Between weeks 2 and 6, a decrease in quadriceps girth was observed followed by repeated increase worm week 6 on. The greatest increase in the girth at the thickest point of the muscle was observed in rehabilitation weeks 6 through 12. A significant decrease in muscle strength was observed in the first 2 weeks after the surgery. In the remaining periods, the strength of the quadriceps muscle continued to grow. The average KSS score increased from 109.1 at week 2 to 162.3 at week 12 after the surgery. CONCLUSIONS: Rehabilitation results in a dynamic increase in the strength of quadriceps between weeks 6 and 12 following reconstruction of anterior cruciate ligament. However, the 12-week rehabilitation period is not sufficient to regain full functionality.

The Polish version of the Process-Based Assessment Tool (PBAT)-The measure of processes of change in psychological interventions.

The aim of this study was to conduct a Polish adaptation of Process-Based Assessment Tool (PBAT), to be used primarily for measurement of the processes of change occurring within psychological interventions, regardless of the therapeutic approach. PBAT includes a set of statements related to negative and positive behaviors in the domains of selection, variation, and retention, as it is theoretically embedded in the evolutionary approach. The tool's construction was determined by resolving the issue of ergodic error, hence employs an idiographic approach. A total of 602 (319 F, 281 M) participants in the age 18-85 took part in the study. Apart from the original 21 PBAT items, two additional items related to self-care vs. self-impatience were tested. The included criterion variables related to the assessment of individual functioning in terms of distress (sadness, anxiety, stress, anger, lack of social support), health (health and vitality levels), the fulfillment or frustration of autonomy, connection, and competence need, as well as well-being (life-satisfaction and sense of professional burnout). The machine learning Boruta algorithm was utilized. PBAT items significantly predicted criterion variables. Positive selection behaviors were strongest predictors of Health, Vitality, Life-satisfaction as well as satisfaction of autonomy, connection and competence needs. Negative selection behaviors were strongest predictors of distress, lack of social support, work burnout as well as the frustration of autonomy, connection and competence needs. Overall, the PBAT items were more predictive of variables encompassing negative aspects of functioning than positive aspects or well-being. The overall relationships and conclusions are consistent with those obtained in the original study. The Polish version of PBAT is recommended for use in further scientific research and therapeutic processes.

The effect of an online acceptance and commitment intervention on the meaning-making process in cancer patients following hematopoietic cell transplantation: study protocol for a randomized controlled trial enhanced with single-case experimental design.

BACKGROUND: Hematopoietic cell transplantation (HCT) is a highly invasive and life-threatening treatment for hematological neoplasms and some types of cancer that can challenge the patient's meaning structures. Restoring meaning (i.e., building more flexible and significant explanations of the disease and treatment burden) can be aided by strengthening psychological flexibility by means of an Acceptance and Commitment Therapy (ACT) intervention. Thus, this trial aims to examine the effect of the ACT intervention on the meaning-making process and the underlying mechanisms of change in patients following HCT compared to a minimally enhanced usual care (mEUC) control group. The trial will be enhanced with a single-case experimental design (SCED), where ACT interventions will be compared between individuals with various pre-intervention intervals. METHODS: In total, 192 patients who qualify for the first autologous or allogeneic HCT will be recruited for a two-armed parallel randomized controlled trial comparing an online self-help 14-day ACT training to education sessions (recommendations following HCT). In both conditions, participants will receive once a day a short survey and intervention proposal (about 5-10 min a day) in the outpatient period. Double-blinded assessment will be conducted at baseline, during the intervention, immediately, 1 month, and 3 months after the intervention. In addition, 6-9 participants will be invited to SCED and randomly assigned to pre-intervention measurement length (1-3 weeks) before completing ACT intervention, followed by 7-day observations at the 2nd and 3rd post-intervention measure. The primary outcome is meaning-related distress. Secondary outcomes include psychological flexibility, meaning-making coping, meanings made, and well-being as well as global and situational meaning. DISCUSSION: This trial represents the first study that integrates the ACT and meaning-making frameworks to reduce meaning-related distress, stimulate the meaning-making process, and enhance the well-being of HCT recipients. Testing of an intervention to address existential concerns unique to patients undergoing HCT will be reinforced by a statistically rigorous idiographic approach to see what works for whom and when. Since access to interventions in the HCT population is limited, the web-based ACT self-help program could potentially fill this gap. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT06266182. Registered on February 20, 2024.

The Polish adaptation of the measurements of rule-governed behaviors: Generalized Pliance Questionnaire, Generalized Tracking Questionnaire and Generalized Self-Pliance Questionnaire.

In some circumstances rule-governed behavior, a behavior that is governed by verbal rules instead of environmental consequences, may be beneficial for human beings. At the same time, rigid rule following is associated with psychopathology. Thus measurement of rule-governed behavior may be of special use in a clinical setting. The aim of this paper is to assess the psychometric properties of Polish adaptations of three questionnaires measuring generalized tendency to engage in various types of rule-governed behaviors: Generalized Pliance Questionnaire (GPQ), Generalized Self-Pliance Questionnaire (GSPQ), Generalized Tracking Questionnaire (GTQ). A forward-backward method was used for translation. Data was collected from two samples: general population (N = 669) and university students (N = 451). To measure the validity of the adapted scales the participants filled in a set of self-assessed questionnaires: Satisfaction with Life Scale (SWLS), Depression, Anxiety, and Stress Scale- 21 (DASS-21), General Self-Efficacy Scale (GSES), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), Valuing Questionnaire (VQ) and Rumination-Reflection Questionnaire (RRQ). The exploratory and confirmatory analyses confirmed the unidimensional structure of each of the adapted scales. All of those scales presented good reliability (internal consistency measured with Cronbach Alpha) and item-total correlations. The Polish versions of questionnaires presented significant correlations in the expected directions with relevant psychological variables in line with the original studies. The measurement occurred invariant across both samples as well as gender. The results provide evidence that Polish versions of GPQ, GSPQ and GTQ present sufficient validity and reliability to be used in the Polish-speaking population.

The role of psychological flexibility in the meaning-reconstruction process in cancer: The intensive longitudinal study protocol.

OBJECTIVES: Meaning-making is an important element of adapting to disease. However, this process is still poorly understood and the theoretical model has not been comprehensively verified yet, particularly in terms of complexity, dynamics, and intraindividual variability. The aim of this study is a deeper understanding of the meaning-reconstruction process in cancer and empirical verification of the integrative meaning-making model of coping extended by the psychological flexibility model. We postulate that psychological flexibility can foster the meaning-making in cancer by building more flexible and workable meaning-making explanations of disease. DESIGN: A daily-diary study conducted for 14 days in patients following the first autologous or allogeneic hematopoietic cell transplantation (HCT). METHODS: Participants (at least 150) will be requested to complete the daily-diary related to daily situational meaning, meaning-related distress, meaning-making, psychological flexibility, meanings made, and wellbeing for 14 days after hospital discharge following HCT. Also, baseline and follow-up assessment of global meaning, wellbeing, and meanings made will be performed. Statistical analysis of the data will be conducted using the multilevel and dynamic structural equation modeling. CONCLUSIONS: The study will fill in the gaps in health psychology in the understanding of the meaning-reconstruction process in cancer by within- and between-person verification of the integrative meaning-making model and its extension by the psychological flexibility model. The data obtained will be used in further research on the development of meaning-making by means of interventions based on psychological flexibility.

Attention bias to infant faces in pregnant women predicts maternal sensitivity.

While research has shown that attention bias to infant faces is linked to parenting, this work is largely cross-sectional and limited to the postpartum period. Because the transition to motherhood from pregnancy to birth constitutes a sensitive period in cortical reorganization linked to the quality of mother-infant interactions, evaluating attention processes in the maternal cortex prior to the experience of mother-infant face-to-face interactions is critical. To assess behavioural attention and neural responses to infant faces in pregnant mothers, behavioral and electrocortical indices were collected using a Go/No Go task, in which infant and adult faces served as distractors. Results showed that heightened processing of infant faces relative to adult faces (behavioral and electrocortical indices) was related to observations of greater maternal sensitivity. These findings show that prenatal maternal attention bias to and the perceived salience of infant faces serves as an individual cognitive hallmark of maternal sensitivity that acts independently of caregiving experience.

The special status of sad infant faces: age and valence differences in adults' cortical face processing.

Understanding the relative and joint prioritization of age- and valence-related face characteristics in adults' cortical face processing remains elusive because these two characteristics have not been manipulated in a single study of neural face processing. We used electroencephalography to investigate adults' P1, N170, P2 and LPP responses to infant and adult faces with happy and sad facial expressions. Viewing infant vs adult faces was associated with significantly larger P1, N170, P2 and LPP responses, with hemisphere and/or participant gender moderating this effect in select cases. Sad faces were associated with significantly larger N170 responses than happy faces. Sad infant faces were associated with significantly larger N170 responses in the right hemisphere than all other combinations of face age and face valence characteristics. We discuss the relative and joint neural prioritization of infant face characteristics and negative facial affect, and their biological value as distinct caregiving and social cues.

Influence of degenerative changes in shoulder joints at ill after the cerebral stroke for the returnof the function of the uppelimp.

INTRODUCTION: with Frequent complications appearing at ill there are disorders of the function and pathological changes in structures of a shoulder joint after the cerebral stroke. Degenerative changes overlapping each other within a shoulder joint to a considerable degree make the process hard for the rehabilitation, they prolong the time of curing and they affect on the quality of life for this group ill. The purpose of our study was assessment of results of ill rehabilitations after the experienced cerebral stroke with degenerative changes in shoulder joints, compared with the control group. Material and the method: The examined Group was made by ill with hemiplegia after the experienced cerebral stroke hospitalized in the Department of the Rehabilitation of the Regional Hospital No. 2 in Rzeszów observed in the period from 1st of January and to 31 st of August 2001, at whom the ultrasound examination degenerative changes were stated in a shoulder joint of the paresised upper limb. The control group was made by ill cured in the same period without degenerative changes in a shoulder joint of the upper limb with paresis. At all ill ultrasound examining structures of shoulder joints was made, a passive scope of the move in the pond was being examined as well as an efficiency of the upper limb was being judged with the Brunnstrom test before and after the rehabilitation. RESULTS: in the control group an improvement in the scope of the move in a shoulder joint and bigger Brunnstrom for the efficiency of the upper limb judged with the test were gotten. Received results were worked out statistically with using the canonical analysis. CONCLUSIONS: While choosing a rehabilitation method of ill with degenerative changes in a shoulder joint after the cerebral stroke, the generative changes in joints of a paresised limbs need to be taken into consideration.

Infant Cries Rattle Adult Cognition.

The attention-grabbing quality of the infant cry is well recognized, but how the emotional valence of infant vocal signals affects adult cognition and cortical activity has heretofore been unknown. We examined the effects of two contrasting infant vocalizations (cries vs. laughs) on adult performance on a Stroop task using a cross-modal distraction paradigm in which infant distractors were vocal and targets were visual. Infant vocalizations were presented before (Experiment 1) or during each Stroop trial (Experiment 2). To evaluate the influence of infant vocalizations on cognitive control, neural responses to the Stroop task were obtained by measuring electroencephalography (EEG) and event-related potentials (ERPs) in Experiment 1. Based on the previously demonstrated existence of negative arousal bias, we hypothesized that cry vocalizations would be more distracting and invoke greater conflict processing than laugh vocalizations. Similarly, we expected participants to have greater difficulty shifting attention from the vocal distractors to the target task after hearing cries vs. after hearing laughs. Behavioral results from both experiments showed a cry interference effect, in which task performance was slower with cry than with laugh distractors. Electrophysiology data further revealed that cries more than laughs reduced attention to the task (smaller P200) and increased conflict processing (larger N450), albeit differently for incongruent and congruent trials. Results from a correlation analysis showed that the amplitudes of P200 and N450 were inversely related, suggesting a reciprocal relationship between attention and conflict processing. The findings suggest that cognitive control processes contribute to an attention bias to infant signals, which is modulated in part by the valence of the infant vocalization and the demands of the cognitive task. The findings thus support the notion that infant cries elicit a negative arousal bias that is distracting; they also identify, for the first time, the neural dynamics underlying the unique influence that infant cries and laughs have on cognitive control.

Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy.

OBJECTIVE: The aim of this study was to assess gait in children with spastic diplegic cerebral palsy rehabilitated with the use of Lokomat active orthosis. DESIGN: A randomized controlled trial. SUBJECTS: Fifty-two children with spastic diplegic cerebral palsy. METHODS: Temporospatial parameters of gait and selected kinematic parameters were assessed. Children from the study group used active orthosis in addition to following a programme of individual exercises. Children in the control group participated only in individual exercises. RESULTS: The difference between the initial and control examinations was statistically insignificant. After the programme was finished, there was a slight improvement in walking speed in both groups. Improvement in the mean walking speed was not significantly different between the groups (p = 0.5905). Range of motion decreased slightly in both groups, and the difference between mean amounts of change was not significant (p = 0.8676). There was significant improvement in maximal range of flexion in the hip joint (p = 0.0065) in the study. It was shown that with a decrease in the mean value of adduction in hip joint, the mean walking speed increased (r = -0.53, p = 0.0011). CONCLUSION: There are several limitations to this study, therefore these results should be regarded as preliminary. Further research consistent with the above indications is needed to investigate the impact of this new treatment option in patients with cerebral palsy.

Investigating social cognition in infants and adults using dense array electroencephalography ((d)EEG).

Dense array electroencephalography ((d)EEG), which provides a non-invasive window for measuring brain activity and a temporal resolution unsurpassed by any other current brain imaging technology¹, ² is being used increasingly in the study of social cognitive functioning in infants and adults. While (d)EEG is enabling researchers to examine brain activity patterns with unprecedented levels of sensitivity, conventional EEG recording systems continue to face certain limitations, including 1) poor spatial resolution and source localization³,42) the physical discomfort for test subjects of enduring the individual application of numerous electrodes to the surface of the scalp, and 3) the complexity for researchers of learning to use multiple software packages to collect and process data. Here we present an overview of an established methodology that represents a significant improvement on conventional methodologies for studying EEG in infants and adults. Although several analytical software techniques can be used to establish indirect indices of source localization to improve the spatial resolution of (d)EEG, the HydroCel Geodesic Sensor Net (HCGSN) by Electrical Geodesics, Inc. (EGI), a dense sensory array that maintains equal distances among adjacent recording electrodes on all surfaces of the scalp, further enhances spatial resolution4,5(,)6 compared to standard (d)EEG systems. The sponge-based HCGSN can be applied rapidly and without scalp abrasion, making it ideal for use with adults7,8 children9,¹°, ¹¹,¹² and infants¹², in both research and clinical 4,5,6,¹³,¹4,¹5settings. This feature allows for considerable cost and time savings by decreasing the average net application time compared to other (d)EEG systems. Moreover, the HCGSN includes unified, seamless software applications for all phases of data, greatly simplifying the collection, processing, and analysis of (d)EEG data. The HCGSN features a low-profile electrode pedestal, which, when filled with electrolyte solution, creates a sealed microenvironment and an electrode-scalp interface. In all Geodesic (d;)EEG systems, EEG sensors detect changes in voltage originating from the participant's scalp, along with a small amount of electrical noise originating from the room environment. Electrical signals from all sensors of the Geodesic sensor net are received simultaneously by the amplifier, where they are automatically processed, packaged, and sent to the data-acquisition computer (DAC). Once received by the DAC, scalp electrical activity can be isolated from artifacts for analysis using the filtering and artifact detection tools included in the EGI software. Typically, the HCGSN can be used continuously for only up to two hours because the electrolyte solution dries out over time, gradually decreasing the quality of the scalp-electrode interface. In the Parent-Infant Research Lab at the University of Toronto, we are using (d)EEG to study social cognitive processes including memory, emotion, goals, intentionality, anticipation, and executive functioning in both adult and infant participants.

Changes in the hip migration percentage and motor function in patients with cerebral palsy treated surgically by multilevel soft tissue release--preliminary report.

BACKGROUND: Disturbed muscle balance secondary to upper motor neuron damage in the course of infantile cerebral palsy (ICP) leads to the development of progressive morphological changes in joints, especially the hip. We analysed changes in Reimers' index (hip migration percentage - MP), and functional ability in CP children after multilevel soft tissue release. MATERIAL AND METHODS: We studied 22 patients with cerebral palsy following one-stage multilevel soft tissue release. The children were examined twice: one day before the surgery and at least 6 months (a mean of 9 months) after the procedure. Hip stability was evaluated radiographically using Reimers' index. Post-operative functional changes were analysed with the Gross Motor Function Measure-88 scale (GMFM-88). RESULTS: Reimers' index decreased post-operatively in 20 right and 18 left hips and increased in 2 right and 4 left hips. Functional ability according to the GMFM scale increased in 17 children (by a mean of 7.1%), did not change in 3 patients with near-maximum pre-operative scores, and worsened in 2 patients. CONCLUSIONS: Our study showed that, when performed for appropriate indications, multilevel soft tissue release surgery can improve hip stability and functional ability in CP children.

Assessment of the impact of orthotic gait training on balance in children with cerebral palsy.

The cerebral palsy symptoms are, among others, balance and gait disorders. The goal of this study was to assess balance capabilities in children with spastic diplegic cerebral palsy rehabilitated using Lokomat active orthosis. The experimental group included children with cerebral palsy, aged 6-14 years, independent standing, level II-III according to GMFCS classification. The cohort was randomly divided into two groups. The balance was assessed on a stabilometric platform. The experimental group was administered a rehabilitation program with the use of Lokomat active orthosis. Statistically significant improvement of balance was found in the experimental group; however, in the control group the improvement was also visible, but not on the statistically significant level. While comparing the results of both groups, significantly bigger improvement was achieved by the children from the experimental group. Lokomat active orthosis is one of the newest devices applied in the rehabilitation. The study shows that training with active orthosis can have positive influence on the balance improvement in children with CP and that further analysis of the impact of such training on locomotive functions is needed.